A hot emotional state is emotionally intense. A cold emotional state is without emotions.

So what are the implications of making decisions when we are in ‘hot’ or ‘cold’ emotional states?

We frequently make long-term decisions on the basis of our, transient, current feelings because we tend to overestimate how long we will continue to experience our current feelings and preferences.

Many decisions involve intense emotional states, either at the time of the decision or at the time when consequences are experienced. This means the decision is often based more on emotion than on the basis of long-term preferences. This may create a ‘hot-cold mismatch’ between the feelings we experience at the time of the decision and those we will experience when the consequences are experienced in the future. A ‘hot-cold mismatch’ is a cognitive bias in which people underestimate the influences of strong emotions and other visceral factors on their preferences and behaviour.

So what are the consequences of this mismatch on the decisions we make and what kind of interventions could minimize the mismatch?

The ‘hot-cold mismatch’ was clearly illustrated in a study by Slevin et al. (1990), when 0% of radiotherapists, 6% of oncologists, and only 10% of healthy people said that they would accept an exhausting course of chemotherapy for an extra three months of life. However, when patients who currently had cancer were asked the same question, around 42% stated that they would accept the chemotherapy for the extra months of life.

Medical decisions are often made when we are in a hot emotional state. We can be highly emotional as a result of having received adverse news, because we are in pain or discomfort, or are stressed as a result of having to make difficult decisions. Many health related decisions, have long-term consequences which involve intense emotional states, either at the time of the decision or at the time when consequences are experienced. In other situations, decisions about our health are made in a ‘cold’ emotional state, but the long-term consequences of the decisions can be ‘hot’. For example, young adults, for whom the prospect of illness may feel remote, make decisions every day that could affect their long-term health, such as whether to smoke cigarettes, how much to exercise, and what to eat.

By designing policies that take into account the 'hot-cold state mismatch', governments can influence the health and financial security of the public. For example, if people were automatically enrolled into programs of organ donations this would significantly increase the number of organ transplants, therefore saving lives (Johnson & Goldstein 2003). Similarly, automatically enrolling staff into pension schemes would increase their savings for retirement (Choi et al. 2003) making them less reliant on state provision in retirement.

So, should there be more preventative policies to decrease the pressure on public services? How do you feel about the government influencing our decisions? Would you welcome more of these policies or do you think they would lead to exploitation of the public?

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